Efthymia Papathanasiou

Duplication of the inferior vena cava: anatomy, embryology and classification proposal

A case of a duplicated inferior vena cava (IVC) along with other anatomical vessel variations in a 72-year-old male cadaver is presented. The anomalous vessels involved, besides the IVC, were the left testicular vein and artery, the left suprarenal artery and a superior accessory left renal artery. Based on the gross appearance of the preaortic anastomotic trunk between the left and right IVC as well as on the underlying embryological features, a classification is proposed: incomplete bilateral duplication of the IVC and complete bilateral duplication of the IVC. The latter can be further divided into three types: major, minor and asymmetric.

Gender and Side-to-Side Differences of Femoral Condyles Morphology: Osteometric Data from 360 Caucasian Dried Femori.

The purpose of the present study was to conduct direct measurements in a large sample of dried femori in order to record certain morphometric parameters of the femoral condyles and determine whether there are gender and side differences. Three hundred sixty (Greek) Caucasian dried femori (180 left and 180 right), from 192 males and 168 females, were measured using a digital caliper. The mean age was 67.52 years. The mean bicondylar width of the femur was 8.86 cm ± 0.42 cm in men and 7.85 cm ± 0.30 cm in women (P < 0.01). The relative values for the medial condylar depth were 6.11 cm ± 0.34 cm and 5.59 cm ± 0.29 cm (P < 0.05); for the lateral condylar depth were 6.11 cm ± 0.33 cm and 5.54 cm ± 0.21 cm (P < 0.01); for the intercondylar width were 2.20 cm ± 0.18 cm and 1.87 cm ± 0.10 cm (P < 0.001); for the intercondylar depth were 2.78 cm ± 0.16 cm and 2.37 cm ± 0.12 cm (P < 0.001). No significant side-to-side difference was observed in any parameter. The femoral condyles differences in anatomy between genders might be useful to the design of total knee prostheses. The contralateral healthy side can be safely used for preoperative templating since there were no significant side differences.

Efficacy of Paracetamol versus Diclofenac for Grade II Ankle Sprains

Background: Ankle sprains are usually treated with the RICE protocol often with nonsteroidal anti-inflammatory drugs (NSAID) for pain reduction. We evaluated the effect of diclofenac, an NSAID, versus paracematol in the reduction of pain and acute edema of severe ankle sprains. Materials and Methods: Ninety patients, 18 to 60 years old, with Grade II acute ankle sprains were randomized into two groups. Group A (45 patients) received for the first 10 days diclofenac 75 mg orally twice per day. Group B (45 patients) received paracetamol 500 mg orally three times per day for the same period. We evaluated ankle joint edema with the Figure-of-Eight method and with the volumetric method, as well as pain with the Visual Analogue Scale (VAS) in both groups. Results: The patients had no significant differences concerning their baseline values (p > 0.05). The ankle joint edema was decreased in both groups (p < 0.001) but there was more edema in group A than in group B at the third post-traumatic day with both measurement methods (p = 0.028/0.025). By the tenth post-traumatic day no difference was found. Pain decreased in both groups at the third day and at the tenth day (p < 0.001). Conclusion: According to these results, diclofenac and paracetamol had the same effect on pain reduction of ankle sprains but more acute ankle edema was present in patients who were treated with diclofenac than in patients who were treated with paracetamol. Level of Evidence: I, Prospective, Randomized Study

Bilateral rectus femoris intramuscular haematoma following simultaneous quadriceps strain in an athlete: a case report

IntroductionBilateral rectus femoris haematoma following a simultaneous strain of the quadriceps muscles is a very rare condition.Case presentationWe report the case of a 21-year-old Greek Caucasian female rowing athlete who was injured on both thighs. She complained of pain and inability to walk. Physical examination revealed tenderness over the thighs and restriction of knee movement. The result of a roentgenogram was normal, and there was no evidence of fracture or patella displacement. Magnetic resonance imaging revealed haematoma formation in both the rectus femoris muscles. The diameters of the left and right haematomas within the muscles were 6 cm and 5 cm, respectively. Therapeutic approaches included compression bandages, ice application, rest, elevation, and administration of muscle relaxant drugs. Active stretching and isometric exercises were performed after three days. The patient was able to walk using crutches two days after the initiation of treatment. On the seventh day, she had regained her full ability to walk without crutches. Non-steroidal anti-inflammatory drugs were administered on the fifth day and continued for one week. Six weeks later, she had pain-free function and the result of magnetic resonance imaging was normal. She was able to resume her training programme and two weeks later, she returned to her previous sport activities and competitions.ConclusionThere are references in the literature regarding the occurrence of unilateral quadriceps haematomas following strain and bilateral quadriceps tendon rupture in athletes. Simultaneous bilateral rectus femoris haematomas after a muscle strain is a rare condition. It must be diagnosed early. The three phases of treatment are rest, knee mobilization, and restoration of quadriceps function.

Rectus abdominis overuse injury in a tennis athlete treated with traumeel.

Summary Background: Rectus abdominis injuries are common in tennis players at all levels of competition. Traumeel® injection can be used for treatment of muscle strains and hematomas. Case Report: A 21-year-old female tennis athlete was injured on the non-dominant rectus abdominis during the cocking phase of the service motion. She suffered from pain and tenderness. One week later, during a serve, she experienced severe pain on the contralateral side of her abdomen. Conservative treatment was performed by the team physician with rest, ice therapy and analgesics for 20 days, but she had recurrent injuries. The ultrasonography and MRI showed hematoma of the rectus abdominis muscle. She was treated with 2 injections of Traumeel® on the 2nd, 4th, 6th post-traumatic day and received 1 injection on the 10th post-traumatic day. She also modified her serve technique. On the fourth post-treatment week the athlete had pain-free function and both the MRI appearance and the size of rectus abdominal muscle were normal. She returned to her sport activities. There is no recurrence of her injury 2 years later. Conclusions: Rectus abdominis hematoma must be diagnosed early. Traumeel® injections are effective, safe and well-tolerated for the treatment of overuse injury of the rectus abdominis following strain.